Circ:Cardiovasc Inte:心源性休克发病率和结局的20年趋势

2019-04-08 xiangting MedSci原创

由于住院期间CS的减少,1997-2017年间CS的发病率下降。CS的院内死亡率从62.8%(1997年)下降到<40%(2017年)。

心源性休克(CS)患者发病率和结局的长期趋势很少见。这项研究首次分析了瑞士20年期间CS发病率和结局的趋势。

AMIS Plus登记(瑞士急性心肌梗死)招募了来自瑞士83家医院的急性心梗患者。分析了1997年至2017年入组CS患者发病率、治疗和院内死亡率的趋势。评估了2005年至2017年血运重建策略对结局的影响。在52808名入选患者中,963名患者由于数据缺失而被排除,保留51842名患者(98%)用于本次分析。总体而言,4090名患者(7.9%)出现急性心梗并发CS,平均年龄为69.6±12.5岁。 总体而言,1997年至2017年间,CS比率从8.7%下降到7.3%(P趋势<0.001;1997-2006 vs.2007-2017)。研究观察到与2007-2017年相比(P趋势,<0.001),1997-2006年间住院CS发病率从7.8%降至3.5%,这被2006-2017年入院时CS增多所部分抵消(2.5%[1997-2006]至4.6%[2007-2017];P趋势,<0.001)。院内死亡率从1997年的62.2%下降到2017年的36.3%(时间趋势P<0.001)。经皮冠脉介入治疗是生存率最强的独立预测因子(优势比,0.36; CI,0.28-0.45; P<0.001)。在急性心梗和多支血管病变患者中,多支血管经皮冠脉介入治疗与院内死亡风险升高相关(优势比,1.88; 95%CI,1.59-2.21),并且是住院期间出现CS的独立预测因子(优势比,1.93; 95%CI,1.62-2.30)。

由于住院期间CS的减少,1997-2017年间CS的发病率下降。CS的院内死亡率从62.8%(1997年)下降到<40%(2017年)。多支血管经皮冠脉介入治疗与住院期间死亡风险升高和出现CS相关。

原始出处:

Lukas Hunziker. Twenty-Year Trends in the Incidence and Outcome of Cardiogenic Shock in AMIS Plus Registry. Circ: Cardiovascular Interventions. 04 April 2019.

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    2020-02-01 quxin068
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    2019-04-10 mhm295

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